Telehealth Secrets 2019: A Data-driven AI-enabled Health Intelligence Platform - David Karow, Human Longevity

1. A Data-driven AI-enabled Health Intelligence Platform
Extending your Healthy Human
Lifespan to 100+ years
David S. Karow, MD, PhD
President
Chief Innovation Officer
Associate Professor UCSD

2. POWERED BY
CONFIDENTIAL - NOT FOR DISTRIBUTION 2
US Life Expectancy at Time of Birth

3. POWERED BY
Extension of the Healthy Human Lifespan

4. POWERED BY
AI-mediated Precision Health Analytics Will Lead to True
Well-care
Sickcare:
Symptom-based detection
Wellcare 1.0:
Pre-symptomatic diagnosis
Wellcare 2.0:
Knowing risk 10 years before
disease onset so that disease
can be avoided
$$$$$ $$$ $

5. POWERED BY
 Whole-genome (30x)
 Microbiome
 Family and Med Hx
 Metabolomics
 Serum Labs
 Gait & Balance
 Neuropsychiatric
 Advanced Imaging (full body
MRI, Coronary CT, cardiac
MRI)
 4D ECHO, EKG
 Cardiac Rhythm Monitor
Measuring What Matters: Deep Quantitative Testing

6. POWERED BY
Actionable Results from 1190 “Healthy” Clients
1.7% with confirmed cancer (pathology
or additional imaging method)
2.5% with body or brain aneurysms
7.0% with moderate/severe cardiovascular risk
(Agatston calcium score >300)
16% with aberrant cardiac structure/
function findings
29%
with elevated liver fat, mostly non-alcoholic
fatty liver disease and associated with
increased visceral abdominal fat (27%
with evidence of insulin resistance)
86%
86% are genetic carriers for recessive
diseases. 24% have a rare genetic mutation
that affects their health. (e.g. Autosomal
dominant rare monogenic variants)
POWERED BY

7. POWERED BY
Case Study
• Client: Healthy Female
• Age: 34
• Finding: 1.3 cm left thyroid
nodule on MRI. Biopsy showed
papillary thyroid cancer
Thyroid Cancer
Trachea
Cervical Spinal Cord
Normal Right
Thyroid Lobe

8. POWERED BY
Case Study
• Client: Healthy Female
• Age: 54
• Finding: 2 cm right lung mass on MRI.
Biopsy confirmed adenocarcinoma
• Notes: She is a non-smoker
Lung Adenocarcinoma

9. POWERED BY
Case Study
• Client: Healthy Female
• Age: 49
• Finding: Newly found 8 mm
left cavernous ICA aneurysm
Brain Aneurysm

10. POWERED BY
Case Study
• Client: Healthy Female
• Age: 45
• Finding: Calcium score of 131, at the 99%
for age and gender.
• Notes: Majority of disease in the LAD.
The 10 year CAD event risk is 5.9% for this
patient as opposed to 1.9% without calcium
score factored into the assessment.
Advanced Coronary
Artery Disease

11. POWERED BY
New Clinically Significant Findings in 40% of Clients
Notes: 1Significant findings that are actionable include findings requiring immediate or near-term follow-up and intervention; 2Long-term clinical findings include discoveries requiring medical attention
or monitoring but not immediately life threatening; 3Clients screened for the first time
40%
Long-term value
findings2 of the
clients we screen3
14.4%
Significant findings
that are actionable1
in the clients
we screen3

12. Health Nucleus: Impacting Real Lives with
Artificial Intelligence

13. POWERED BY
The Story of You: Measuring what Matters

14. POWERED BY
• Reality
• High performance and
Longevity are linked
• It starts with a fountain of
data
The Fountain of Youth

15. POWERED BY
CONFIDENTIAL - NOT FOR DISTRIBUTION 15
Knowledge Empowers You to Take Charge of Your
Health and Performance
• What is my condition now?
• What is my actual risk for chronic age related disease?
- Not population level risk. What is my risk?
- In 1 year? In 5 years?
• Live to 100+. What is the disease that will get in my way
• What can I do to mitigate my risk?

16. POWERED BY
Imaging-Based Biomarkers of Performance (and
Metabolic Syndrome)
*Provisional Patent
Fat Composition
Value Normal
Vat 2.79 L 1.19–2.76 L
ASAT 9.90 L 4.98–9.40 L
Total Abdominal Fat 12.70 L 6.74–12.04 L
Muscle Composition
Value Normal
Left Anterior Thigh 1.45 L 1.33–1.67 L
Left Posterior Thigh 2.76 L 2.70–3.25 L
Right Anterior Thigh 1.49 L 1.37–1.66 L
Right Posterior Thigh 2.92 L 2.71–3.29 L
Total Thigh 8.62 L 8.09–9.79 L
Fully Automated Body Composition
from MRI-derived Dixon Imaging

17. POWERED BY
AI-Driven Personalized Risk and Recommendations
8 Year Pre-Symptomatic Risk Prediction of Alzheimer’s
Integrated Feature Vector
Epidemiology
Cloud-Based
MRI Analysis
Genomic Health
Risk Metrics

18. POWERED BY
How much do you believe we have control over lowering our Alzheimer’s risk
through our diet?
Dr. Ed Blonz, UCSF: “Through nutrition and lifestyle, I think we have a
tremendous amount of control. I mentioned ApoE4. Just because you have
ApoE4 is no guarantee that you’re going to get Alzheimer’s”. October 29,
2018, Being Patient Newsletter
Dr. Gary Small, UCLA, Director of UCLA Longevity Center: “There are
sensible things you can do to help lower your risk of any kind of dementia.
For example, a third of dementia cases can be prevented with lifestyle
changes.” NY Times, May 13, 2019
1/3 of the Risk for Dementia is due to
Modifiable Risk Factors

19. Health Nucleus Platform Overview

20. POWERED BY
* Ages 50 – 74, 2015 in USA; Adapted from Institute of Health Metrics and Evaluation, University of Washington.
http://www.healthdata.org/results/data-visualizations
The Impact of Preventable Age-Related Chronic Disease: 1/3
of us Living to Age 50 Won’t Live to Age 75
MALE
39%
RISK OF DEATH*
CARDIOVASCULAR
30%
CANCER
33%
FEMALE
24%
RISK OF DEATH*
CANCER
40%
CARDIOVASCULAR
23%
NEUROLOGIC
3%
CIRRHOSIS
5%
DIABETES
7%
RESPIRATORY
6%
OTHER
16%
RESPIRATORY
8%
DIABETES
8%
CIRRHOSIS
4%
NEUROLOGIC
4%
OTHER
13%

21. POWERED BY
Solution: Data-driven Precision Health Platform that Enables
pre-symptomatic Diagnosis
Code: Family History
Integration:
Physician
Core: Physical
exam
Last 30+ years
Code: Whole genome sequencing
Integration:
AI & ML
Core: Whole Body MRI
with imaging biomarkers
Next generation
Blood: Basic
bloodwork
Blood: Advanced
Bloodwork e.g.
Metabolome

22. POWERED BY
• Novel discovery center integrating whole
genome sequencing with advanced
imaging and other phenotype investigations
for early detection and risk assessment
• Machine learning-based integrated
diagnostics predict lifetime and short term
risk of chronic age related disease
• Case review by team of geneticists,
bioinformaticians, radiologists & physicians
What is the Health
Nucleus Platform?

23. POWERED BY
What is the Health Nucleus Platform?
Whole Genome
Sequencing
Health Assessment
Questionnaire +
Family History
MRI Imaging
(Brain, Body)
Core Laboratory
Analysis
Optional:
Cardiac MRI
Ziopatch
Microbiome
Cologuard
CT Coronary
Calcium Score
Input Output

24. POWERED BY
Tenants of Longevity and
Performance

25. POWERED BY
CONFIDENTIAL - NOT FOR DISTRIBUTION 25
10 Tenants of Longevity and High Performance
• Sleep
• Program not pills!
• Know your number
• Daily aerobic exercise & strength training/muscle building (1-2 hours daily total)
• Balanced diet > consider intermittent fasting
• Minimize isolation
• Consistent sleep-wake
• Minimize seeking
• One day a week of mental and physical rest
• Meditation

26. POWERED BY
CONFIDENTIAL - NOT FOR DISTRIBUTION 26
Medicine is moving from a Clinical science sometimes
supported by data to a Data science supported by
physicians

27. Powered by Human Longevity, Inc.
Unparalleled
Unprecedented